Clinical impact, safety, and efficacy of single- versus Dual-Coil ICD leads in MADIT-CRT

Valentina Kutyifa, Anne Christine Huth Ruwald, Mehmet K. Aktas, Christian Jons, Scott McNitt, Bronislava Polonsky, Laszlo Geller, Bela Merkely, Arthur J. Moss, Wojciech Zareba, Poul Erik Bloch Thomsen

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30 Citations (Scopus)


Single- versus Dual-Coil ICD Leads Background Current data on efficacy, safety and impact on clinical outcome of single- versus dual-coil implantable cardioverter-defibrillator (ICD) leads are limited and contradictory. Methods Defibrillation threshold (DFT) at implantation and first shock efficacy were compared in patients implanted with single- versus dual-coil ICD leads in MADIT-CRT. The risk for atrial tachyarrhythmias and all-cause mortality were evaluated. Short- (< 30 days after the implantation) and long-term (throughout the entire study duration) complications were assessed. Results Patients with dual-coil ICD leads had significantly lower DFTs compared to patients with single-coil ICD leads (17.6 ± 5.8 J vs 19.4 ± 6.1 J, P < 0.001). First shock efficacy was similar among patients with dual and single-coil ICD leads (89.6% vs 92.3%, P = 1.00). When comparing patients with dual versus single-coil ICD leads, there was no difference in the risk of atrial tachyarrhythmias (HR = 1.57, 95% CI: 0.81-3.02, P = 0.18), or in the risk of all-cause mortality (HR = 1.10, 95% CI: 0.58-2.07, P = 0.77). Patients implanted with single- or dual-coil ICD lead had similar short and long-term complication rates (short-term HR = 0.96, 95% CI: 0.56-1.65, P = 0.88, long-term procedure-related HR = 0.99, 95% CI: 0.62-1.59, P = 1.00, long-term ICD lead related: HR = 1.2, 95% CI: 0.5-2.9, P = 0.68) during the mean follow-up of 3.3 years. Conclusions Patients with single-coil ICD leads have slightly higher DFTs compared to those with dual-coil leads, but the efficacy, safety, and clinical impact on atrial tachyarrhythmias, and mortality is similar. Implantation of single-coil ICD leads may be favorable in most patients.

Original languageEnglish
Pages (from-to)1246-1252
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Issue number11
Publication statusPublished - Nov 1 2013


  • MADIT-CRT mortality
  • atrial arrhythmias
  • heart failure
  • implantable cardioverter defibrillators

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Kutyifa, V., Huth Ruwald, A. C., Aktas, M. K., Jons, C., McNitt, S., Polonsky, B., Geller, L., Merkely, B., Moss, A. J., Zareba, W., & Bloch Thomsen, P. E. (2013). Clinical impact, safety, and efficacy of single- versus Dual-Coil ICD leads in MADIT-CRT. Journal of Cardiovascular Electrophysiology, 24(11), 1246-1252.